| NPI | 1790022606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 121477) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 1041C0700X Social Worker Clinical (Licence: 121477) | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2024-07-31 |