| NPI | 1790054591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 19690) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ND 3920) |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2011-12-22 |