| NPI | 1790989978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 077648) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2005015072) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2010-09-30 |