| NPI | 1922643857 |
|---|---|
| Former Name | LYLA RYCKMAN GREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801112317) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801104664) |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2023-05-18 |