| NPI | 1386662559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801004548) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6801004548) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2009-03-24 |