| NPI | 1639678626 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801106963) | 
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801115963) | 
| Enumeration Date | 2018-02-06 | 
| Last Update Date | 2025-09-10 |