| NPI | 1982672614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: KS 1194) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MO SW003595) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2007-07-08 |