| NPI | 1790782803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 1251) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IN 34004523) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2007-07-08 |