| NPI | 1104237460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801097574) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150.014619) |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2021-07-23 |