| NPI | 1598659732 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6851120432) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2025-06-04 |
| Last Update Date | 2025-06-19 |