| NPI | 1477023653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801118782) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI SA0090077) |
| Enumeration Date | 2018-11-29 |
| Last Update Date | 2024-08-18 |