| NPI | 1861356503 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS C11870) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TN 9989) |
| Enumeration Date | 2025-12-15 |
| Last Update Date | 2026-02-27 |