NPI | 1982352050 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-22048) |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
Enumeration Date | 2022-03-16 |
Last Update Date | 2024-02-13 |