| NPI | 1811221708 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 54872) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS11362) | 
| 1041C0700X Social Worker, Clinical (Licence: CO 956) | |
| Enumeration Date | 2009-09-24 | 
| Last Update Date | 2012-10-22 |