| NPI | 1962573832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MD 00202) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: DC LC300400) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2007-07-08 |