| NPI | 1689079998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA LICSW121270) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801080292) |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2025-03-20 |