| NPI | 1710391347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801095097) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IA 137020) |
| 1041C0700X Social Worker, Clinical (Licence: MN 35886) | |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2026-07-30 |