| NPI | 1790800191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 25291) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WY LCSW-451) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-02-21 |