| NPI | 1962981712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 094792) |
| Additional Taxonomies | 104100000X Social Worker |
| 104100000X Social Worker (Licence: NY 107143) | |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2023-03-14 |