| NPI | 1912366576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904010115) |
| Additional Taxonomies | 104100000X Social Worker (Licence: LA 13034) |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2018-03-17 |