| NPI | 1902035496 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904003949)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NM X06438)  | 
| Enumeration Date | 2009-07-06 | 
| Last Update Date | 2009-07-06 |