| NPI | 1740690908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW12118) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: GA CSW002350) |
| 1041C0700X Social Worker, Clinical (Licence: GA CSW002350) | |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2021-08-13 |