| NPI | 1861264277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: PA SW136745) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: PA SW136745) |
| 261QS1000X Clinic/Center, Student Health (Licence: PA SW136745) | |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2023-10-30 |