| NPI | 1831668912 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW023430) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC06083000) |
| Enumeration Date | 2018-11-18 |
| Last Update Date | 2023-05-04 |