| NPI | 1396987285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TN 5680) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 6801085968) |
| 1041S0200X Social Worker School (Licence: TN 000591153) | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI 200876) | |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2014-01-02 |