| NPI | 1962903203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 22712) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2017038753) |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2018-10-17 |