| NPI | 1801120100 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801092203)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 103K00000X Behavior Analyst | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-09-21 | 
| Last Update Date | 2021-03-15 |