| NPI | 1780091611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 13320) |
| Additional Taxonomies | 104100000X Social Worker (Licence: LA 11951) |
| 1041C0700X Social Worker, Clinical (Licence: VA 0904010522) | |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2022-02-17 |