| NPI | 1609268416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801106127) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MI 6801096723) |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2021-01-27 |