| NPI | 1467724765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801081139) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-01093) |
| 1041S0200X Social Worker, School (Licence: MI 0000) | |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2012-02-01 |