| NPI | 1912309444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 000124911) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2022-07-12 |