| NPI | 1912964420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX 42198) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: CO 989322) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2007-07-08 |