| NPI | 1912420647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL ISW8640) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2022-07-21 |