| NPI | 1831135920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 020614) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TP2701X Psychologist, Group Psychotherapy | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2012-09-11 |