| NPI | 1770975344 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904013122)  | 
| Additional Taxonomies | 104100000X Social Worker (Licence: VA 0903001948)  | 
| 1041C0700X Social Worker, Clinical (Licence: PA CW019915)  | |
| Enumeration Date | 2015-02-19 | 
| Last Update Date | 2021-08-02 |