NPI | 1861950404 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801095947) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 53404) |
Enumeration Date | 2019-03-02 |
Last Update Date | 2019-03-02 |