| NPI | 1184239568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801107713) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 6801107713) |
| 1041C0700X Social Worker, Clinical (Licence: MI 6801107713) | |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2022-06-14 |