| NPI | 1912303611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA LICSW125031) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2014-11-07 |
| Last Update Date | 2025-07-30 |