| NPI | 1962596601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 8817) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 069473) |
| 104100000X Social Worker (Licence: GA MSW004199) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2010-03-23 |