| NPI | 1891069100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801095472) |
| Additional Taxonomies | 104100000X Social Worker |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2024-05-13 |