NPI | 1790025005 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 52241) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MT 2197) |
Enumeration Date | 2013-02-22 |
Last Update Date | 2013-02-22 |