| NPI | 1417324666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801122812) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2026-08-31 |