| NPI | 1922249853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801089428) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: MI 6801089428) |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2023-06-22 |