NPI | 1316563885 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801114122) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6801105698) |
101YM0800X Counselor, Mental Health (Licence: MI 6801114122) | |
Enumeration Date | 2020-06-22 |
Last Update Date | 2023-09-13 |