NPI | 1619492071 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801108388) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6801108388) |
Enumeration Date | 2017-08-07 |
Last Update Date | 2024-10-17 |