| NPI | 1104192400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW15094) |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker, Clinical (Licence: MI 6801098084) | |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2019-02-28 |