| NPI | 1518255140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801083892) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: MI 6801083892) |
| Enumeration Date | 2011-07-17 |
| Last Update Date | 2014-05-01 |