| NPI | 1912215070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 3745) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KY 5827) |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2018-03-17 |