| NPI | 1215495262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801109335) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 16329) |
| Enumeration Date | 2019-03-08 |
| Last Update Date | 2022-04-28 |