| NPI | 1881964633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 3905) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 6249) |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2019-05-23 |