| NPI | 1265924450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801107705) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801102593) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 2-01324) | |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2020-09-03 |