| NPI | 1750457446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 12987) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IA 01028) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2012-01-19 |