| NPI | 1295487320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801109410) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MN 25155) |
| Enumeration Date | 2022-01-20 |
| Last Update Date | 2022-01-20 |