| NPI | 1992108534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: TX 59069) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C010567) |
| 1041C0700X Social Worker, Clinical (Licence: OH I.210318189.SUPV) | |
| Enumeration Date | 2014-09-26 |
| Last Update Date | 2022-10-31 |