| NPI | 1790124030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801108905) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2021-10-04 |