| NPI | 1295103273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6851115309) |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker, Clinical (Licence: MA 222496) | |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2023-05-09 |