| NPI | 1780167460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 121493) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 222032) |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2018-10-02 |