| NPI | 1962562660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TN LSW0000003958) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: VA 0904004885) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2007-07-08 |