| NPI | 1063512671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801080778) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801080778) |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301013818) | |
| 103T00000X Psychologist (Licence: MI 6301013818) | |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2009-02-13 |