| 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 |