| NPI | 1780085597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801071630) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-02780) |
| 104100000X Social Worker (Licence: MI 6801071630) | |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2014-09-11 |