| NPI | 1104866201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801033405) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401004267) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2020-01-09 |