| NPI | 1164885109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401017528) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6802088621) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2023-01-03 |