| NPI | 1750863908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: FL SW13939) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MA 117018-SW-LICSW) |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2018-09-04 |