| NPI | 1972739225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 121962) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 21696) |
| Enumeration Date | 2009-06-01 |
| Last Update Date | 2020-09-10 |