| NPI | 1063962447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801099382) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801099382) |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2026-07-07 |