| NPI | 1790184505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2011016989) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KS 4111) |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2014-08-18 |