| NPI | 1184608630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 65646) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801063746) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2022-11-15 |