| NPI | 1356757058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801094991) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 129363-121) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 15841-132) | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2018-11-13 |