| NPI | 1760862023 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801086344)  | 
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: MI 6801086344)  | 
| 104100000X Social Worker | |
| Enumeration Date | 2015-06-02 | 
| Last Update Date | 2015-07-09 |