| NPI | 1912120742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW004417) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW 7604) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2012-10-19 |