| NPI | 1407126030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801061604) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL PSW 836) |
| 1041C0700X Social Worker, Clinical (Licence: MI 6801061604) | |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2023-04-06 |