| NPI | 1962628412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO LCSW989705) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY LCSWPR012090) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2017-01-12 |