| NPI | 1982004073 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 23712) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801094335) | 
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2014-08-26 | 
| Last Update Date | 2023-06-28 |