| NPI | 1972192532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: FL 101029) |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2021-01-18 |
| Last Update Date | 2021-04-12 |