| 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 |