| NPI | 1912119017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801088037) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: GA CSW005336) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2016-08-05 |