| NPI | 1912363672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.017299) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 61516) |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2016-01-11 |