| NPI | 1629550223 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801108845) | 
| Additional Taxonomies | 156F00000X Technician/Technologist | 
| Enumeration Date | 2018-08-30 | 
| Last Update Date | 2022-05-25 |