| NPI | 1083999379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801092891) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6801092891) |
| Enumeration Date | 2011-10-18 |
| Last Update Date | 2022-10-20 |