| NPI | 1770513962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 1264573501) |
| Additional Taxonomies | 104100000X Social Worker (Licence: UT 126457-3501) |
| 104100000X Social Worker (Licence: ID LCSW-39191) | |
| 1041C0700X Social Worker, Clinical (Licence: ID LCSW-39191) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2024-01-16 |