| NPI | 1790037992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MT 2271-LCSW) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: MT #00010138) |
| 225C00000X Rehabilitation Counselor (Licence: MT #00010138) | |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2016-01-06 |