| NPI | 1316325111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801113653) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2025-01-13 |