| NPI | 1952751430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-16872) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WY LCSW-754) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2018-10-01 |