| NPI | 1649515404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801083977) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801083977) |
| 101YM0800X Counselor, Mental Health (Licence: MI 6801083977) | |
| Enumeration Date | 2012-12-05 |
| Last Update Date | 2012-12-15 |