| NPI | 1962723759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OR L6477) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 6801092163) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2016-09-26 |