| NPI | 1922536655 |
|---|---|
| Former Name | MIKAELA JACKLIN BURKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 093750-01) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2022-09-26 |