| NPI | 1861042566 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW020960) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA CW020960) |
| Enumeration Date | 2019-09-14 |
| Last Update Date | 2020-04-02 |