| NPI | 1902592553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MO 2023012755) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: KS 06093) |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2023-10-03 |