| NPI | 1659651222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801091669) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6801091669) |
| 101YM0800X Counselor, Mental Health (Licence: MI 6801091669) | |
| Enumeration Date | 2011-08-26 |
| Last Update Date | 2014-01-28 |