| NPI | 1790151819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: AZ 15116) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MO 005658) |
| Enumeration Date | 2015-08-12 |
| Last Update Date | 2015-08-12 |