| NPI | 1962755843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 64679) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 083038) |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2018-05-21 |