| NPI | 1962886994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 18873) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 129747-121) |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2021-07-26 |