| NPI | 1790071348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CT 007636) |
| Additional Taxonomies | 1041S0200X Social Worker School (Licence: CT C072010000821) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2011-06-22 |