| NPI | 1467578526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801093954) |
| Additional Taxonomies | 225800000X Recreation Therapist (Licence: 225800000X) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2022-07-18 |