| NPI | 1245671312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801115505) |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care (Licence: MI 6801115505) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2025-03-03 |