| NPI | 1912143165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 217467) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: RI CSW01289) |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2011-11-30 |