| NPI | 1700209913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801095358) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MI 6801095358) |
| Enumeration Date | 2014-01-23 |
| Last Update Date | 2023-03-14 |