NPI | 1659439073 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801018476) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI SW 6801018476) |
Enumeration Date | 2006-12-05 |
Last Update Date | 2010-11-03 |