| NPI | 1528629771 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801110609) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801104524) | 
| Enumeration Date | 2019-06-27 | 
| Last Update Date | 2021-07-30 |