| NPI | 1962172031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: WA LW61431933) |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker, Clinical (Licence: MI 6801108700) | |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2023-05-30 |