| NPI | 1013242767 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801091423) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: UT 352103-3501) | 
| 1041C0700X Social Worker, Clinical (Licence: CO CSW.09927714) | |
| Enumeration Date | 2009-10-14 | 
| Last Update Date | 2024-05-31 |