| NPI | 1962654350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 4430) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 3044) |
| 1041C0700X Social Worker, Clinical (Licence: WI 7515-123) | |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2009-05-21 |