| NPI | 1750628053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801101709) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801101709) |
| 1041C0700X Social Worker, Clinical (Licence: MD 15853) | |
| Enumeration Date | 2013-01-08 |
| Last Update Date | 2019-11-19 |