| NPI | 1699459701 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801016889) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW10030) | 
| Enumeration Date | 2023-06-12 | 
| Last Update Date | 2023-06-12 |