| NPI | 1962744292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: KY 252492) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S1200322) |
| 1041C0700X Social Worker, Clinical (Licence: KY 252492) | |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2019-01-03 |