| NPI | 1912400524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MN 26747) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: CA 77000) |
| Enumeration Date | 2018-03-10 |
| Last Update Date | 2018-03-10 |