| NPI | 1821301623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 21337) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WY PCSW-425) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2019-01-08 |