| NPI | 1790264752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 106678) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MA 106679) |
| Enumeration Date | 2018-08-10 |
| Last Update Date | 2018-08-10 |