| NPI | 1912400607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 121841) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C015073) |
| Enumeration Date | 2018-03-09 |
| Last Update Date | 2023-06-05 |