| NPI | 1790141414 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801105025) | 
| Additional Taxonomies | 104100000X Social Worker | 
| 1041C0700X Social Worker, Clinical (Licence: MI 6801100643) | |
| Enumeration Date | 2016-01-11 | 
| Last Update Date | 2025-08-29 |