| NPI | 1407509359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801116734) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 104788) |
| Enumeration Date | 2022-02-01 |
| Last Update Date | 2025-12-11 |