| NPI | 1891283834 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.1600633) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: I.2002173) |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2020-06-12 |