| NPI | 1811623143 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 16559) |
| Additional Taxonomies | 104100000X Social Worker (Licence: SC 16559) |
| Enumeration Date | 2022-07-28 |
| Last Update Date | 2025-01-03 |