| NPI | 1063848315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801098496) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S. 1302693) |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2020-02-21 |