| NPI | 1639620313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801107131) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 098352) |
| 1041C0700X Social Worker, Clinical (Licence: NY 089050) | |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2022-09-13 |