| NPI | 1588963474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801092618) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801092618) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2017-05-04 |