| NPI | 1902203755 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW-35099)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ME LC14843)  | 
| Enumeration Date | 2014-11-21 | 
| Last Update Date | 2020-07-17 |