| NPI | 1790221653 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW024389) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 09326-01) | 
| Enumeration Date | 2017-01-16 | 
| Last Update Date | 2024-03-22 |