| NPI | 1649385410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801078207) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904006520) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2007-08-01 |