| NPI | 1962819953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC14764) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 116664) |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2014-07-22 |