| NPI | 1770954695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 68011033961) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801103961) |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2022-10-20 |