| NPI | 1649654542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801070634) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801070634) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2017-12-26 |