| NPI | 1902191398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 22808) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 16868) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2022-10-17 |