| NPI | 1053611897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801107865) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801042466) |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2021-04-20 |