| NPI | 1770126955 |
|---|---|
| Former Name | MADISON QUEENER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801119521) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2024-12-16 |