| NPI | 1063607380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801093727) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 077435) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2016-06-27 |