| NPI | 1710369616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW12722) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801095005) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2015-06-26 |