| NPI | 1639622897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801118277) |
| Additional Taxonomies | 104100000X Social Worker |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2024-04-17 |