| NPI | 1790164812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 086538-1) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 093478-1) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2018-03-16 |