| NPI | 1902451123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW007278) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: GA MSW007640) |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2022-02-24 |