| NPI | 1083976070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 55866) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801092462) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2022-03-21 |