| NPI | 1962069955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 096739) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 105099) |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2024-02-07 |