| NPI | 1891987020 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW 5130) | 
| Additional Taxonomies | 247200000X Technician, Other (Licence: FL MA 3599) | 
| Enumeration Date | 2007-08-12 | 
| Last Update Date | 2007-08-12 |