| NPI | 1902295736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC C010324) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NC 20957) |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2016-09-09 |