| NPI | 1053844795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801107172) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2023-03-24 |