| NPI | 1104170232 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801100387)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34006602A)  | 
| 104100000X Social Worker (Licence: MI 6801100387)  | |
| Enumeration Date | 2012-10-26 | 
| Last Update Date | 2020-12-16 |