| NPI | 1750443602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 12794) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 090-400-1872) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2015-05-19 |