| NPI | 1639884083 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6851115784) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: 6851115784) | 
| Enumeration Date | 2023-01-19 | 
| Last Update Date | 2023-09-11 |