| NPI | 1588119960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801100898) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2022-07-21 |