NPI | 1295401776 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801112260) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NY 064138) |
Enumeration Date | 2021-08-17 |
Last Update Date | 2021-12-22 |