| NPI | 1720184930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801082709) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 203961) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-01935) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: MI 250346) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2011-01-21 |