| NPI | 1750630703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 119462) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 218511) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2016-12-13 |