| NPI | 1750666871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MT BBH-LCSW-LIC-8374) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: ID LCSW - 27646) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2018-10-08 |