| NPI | 1760505879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L4091) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 039002) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2007-12-03 |