| NPI | 1902158173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 118972) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 079222-1) |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2023-07-20 |