| NPI | 1760736441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801003967) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MI 6401006072) |
| Enumeration Date | 2012-11-02 |
| Last Update Date | 2012-12-11 |