| NPI | 1902235336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 252198) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KY 4505) |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2016-08-23 |