| NPI | 1104219971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801117532) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6801117532) |
| Enumeration Date | 2015-03-18 |
| Last Update Date | 2024-03-06 |