| NPI | 1609150275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 68010933800) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401009846) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15626-132) | |
| 101YP2500X Counselor, Professional (Licence: WI 3808-125) | |
| 1041C0700X Social Worker, Clinical (Licence: WI 8130-123) | |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2021-05-25 |