| NPI | 1952310625 |
|---|---|
| Doing Business As | |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 6867-123) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 640-124) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2007-07-08 |