| NPI | 1790031607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS C7440) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: LA 12091) |
| Enumeration Date | 2012-07-29 |
| Last Update Date | 2019-06-03 |