| NPI | 1689079378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 2395040401) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2023-05-02 |