| NPI | 1972859932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AK 1125) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AK PSYP679) |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2022-04-18 |