| NPI | 1063301265 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6851120194) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6851120194) | 
| 101Y00000X Counselor (Licence: MI 6851120194) | |
| Enumeration Date | 2025-07-01 | 
| Last Update Date | 2025-07-01 |