| NPI | 1417379959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801078691) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MI 6801078691) |
| Enumeration Date | 2014-01-17 |
| Last Update Date | 2014-01-17 |