| NPI | 1023358314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI L2395721) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI L2395721) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI L2395721) | |
| 101YP2500X Counselor, Professional (Licence: MI L2395721) | |
| Enumeration Date | 2013-02-22 |
| Last Update Date | 2016-02-12 |