| NPI | 1962423079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 077578) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 111291) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2022-01-25 |