| NPI | 1306928239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801100246) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 048432) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2018-03-17 |