| NPI | 1912055377 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801090121)  | 
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6803084991)  | 
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI CACR)  | |
| 101YP2500X Counselor, Professional (Licence: MI CCSR)  | |
| 171M00000X Case Manager/Care Coordinator (Licence: MI 6801090121)  | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI S-20076)  | |
| Enumeration Date | 2007-01-08 | 
| Last Update Date | 2012-05-21 |