| NPI | 1891344511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: KY 253895) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: OH I10019-SUPV) |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2019-09-05 |