| NPI | 1992115802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 000124610) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2024-04-03 |