| NPI | 1720174824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401002476) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 6401002476) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2019-02-21 |