| NPI | 1528299617 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801085560) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: MI 6801085560) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2009-08-06 |