| NPI | 1750999868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MT BBH-LCSW-LIC-43915) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: ID LCSW-40000) |
| 1041C0700X Social Worker Clinical (Licence: OK 7650) | |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2022-08-01 |