| NPI | 1538721105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801119727) |
| Additional Taxonomies | 156F00000X Technician/Technologist |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2026-05-07 |