| NPI | 1871092205 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 17396)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 11193)  | 
| 104100000X Social Worker (Licence: CT 1413)  | |
| Enumeration Date | 2018-02-12 | 
| Last Update Date | 2024-12-16 |