| NPI | 1912428061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WV DP00944732) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904014127) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2023-01-04 |