| NPI | 1396158366 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041S0200X Social Worker, School (Licence: MI 6801080607) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801080607) | 
| Enumeration Date | 2014-06-08 | 
| Last Update Date | 2014-06-08 |