| NPI | 1831638659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801097665) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MI 6801097665) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2021-09-14 |