| NPI | 1811263288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401014423) |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate (Licence: MI 3202002671) |
| 1041C0700X Social Worker, Clinical (Licence: MI 6802085626) | |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2022-03-22 |