| NPI | 1306954797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801014309) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI C-00638) |
| 103T00000X Psychologist (Licence: MI 6301006119) | |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2024-03-22 |