| NPI | 1902066962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO 1563) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 36763) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2012-10-04 |