| NPI | 1508292038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MN 29658) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801095783) |
| Enumeration Date | 2013-09-16 |
| Last Update Date | 2021-12-09 |