| NPI | 1811083439 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 104100000X Social Worker (Licence: MN 11655)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW7155)  | 
| 1041C0700X Social Worker, Clinical (Licence: LA 11928)  | |
| Enumeration Date | 2006-10-04 | 
| Last Update Date | 2013-02-19 |