| NPI | 1962784256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2011011573) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL 15277) |
| 1041C0700X Social Worker, Clinical (Licence: KS 2209) | |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2026-03-26 |