| NPI | 1700220019 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801110452) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH S1201548) | 
| 101YM0800X Counselor, Mental Health (Licence: MI 6801110452) | |
| Enumeration Date | 2013-04-18 | 
| Last Update Date | 2024-10-24 |