| NPI | 1902789316 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: PA SW132533) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: PA SW132533) |
| Enumeration Date | 2025-07-31 |
| Last Update Date | 2025-07-31 |