| NPI | 1912262452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 120442) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 083605) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2019-02-27 |