| NPI | 1902185762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C011222) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: RI C512) |
| 104100000X Social Worker (Licence: RI CSW01442) | |
| 1041C0700X Social Worker, Clinical (Licence: RI ISW02454) | |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2018-03-17 |