| NPI | 1841542149 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2012018580)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KS 4166)  | 
| Enumeration Date | 2012-10-10 | 
| Last Update Date | 2012-10-11 |