| NPI | 1780164012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 11247) |
| Additional Taxonomies | 104100000X Social Worker |
| 104100000X Social Worker (Licence: CT 4413) | |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2020-11-06 |