NPI | 1578820643 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801089977) |
Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: MI 6801089977) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 6801089977) | |
Enumeration Date | 2012-04-13 |
Last Update Date | 2012-04-13 |