| NPI | 1003275819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801114053) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 1041S0200X Social Worker School (Licence: MI 6801114053) | |
| 1041S0200X Social Worker School (Licence: MI 6851104857) | |
| Enumeration Date | 2016-02-22 |
| Last Update Date | 2022-02-08 |