| NPI | 1316184419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801082561) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI C-01184) |
| 104100000X Social Worker (Licence: MI 6801082561) | |
| Enumeration Date | 2009-01-12 |
| Last Update Date | 2009-01-12 |