| NPI | 1962705731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801014697) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI L1543510) |
| Enumeration Date | 2010-12-16 |
| Last Update Date | 2016-03-10 |