| NPI | 1194164558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801106797) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 104100000X Social Worker (Licence: MI 6801095621) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2020-08-13 |