NPI | 1073119632 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6851117943) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: MI SP0000000792258) |
Enumeration Date | 2020-12-09 |
Last Update Date | 2024-06-05 |