NPI | 1962897652 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-15766) |
Additional Taxonomies | 103T00000X Psychologist |
104100000X Social Worker (Licence: AZ LMSW 13871) | |
Enumeration Date | 2015-03-31 |
Last Update Date | 2021-09-05 |