| NPI | 1083964530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801100329) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801100329) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2019-02-26 |