| NPI | 1801263280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 220997) |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2015-09-02 |