| NPI | 1477672756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-12459) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801085600) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2010-04-09 |