| NPI | 1063886711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: 6801114477) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801098303) |
| Enumeration Date | 2015-11-18 |
| Last Update Date | 2025-01-29 |