| NPI | 1790841856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 120000) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MT 645LCSW) |
| 1041C0700X Social Worker, Clinical (Licence: TN LSW4581) | |
| Enumeration Date | 2006-12-30 |
| Last Update Date | 2024-12-31 |