| NPI | 1922503200 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW024218) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA 128886) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2025-02-19 |