| NPI | 1114548385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801062502) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 6801062502) |
| 1041S0200X Social Worker School (Licence: MI 6801062502) | |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2020-04-29 |