| NPI | 1942753165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801105172) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6801105172) |
| 101YM0800X Counselor Mental Health (Licence: MI 6801105172) | |
| 1041S0200X Social Worker School (Licence: MI 6801105172) | |
| 247200000X Technician, Other | |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2019-10-30 |