| NPI | 1275556169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 252104) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 675337) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2019-10-09 |