| NPI | 1992749261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MO 2001027396) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: KS 2225) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2017-01-31 |