| NPI | 1902904048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6802070568) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401006415) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2022-06-15 |