| NPI | 1790702645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VA 0904002674) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: GA CSW004983) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2015-08-11 |