| 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) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2022-04-20 |