| NPI | 1871871228 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC01112300) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 096815-01) |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2025-02-20 |