| NPI | 1073568374 |
|---|---|
| Former Name | MITZI AUDRA JANUKAITIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801083573) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801083573) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2021-10-20 |