| NPI | 1124467568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801095539) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801095539) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2018-10-04 |