NPI | 1982051553 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801099407) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6801099407) |
Enumeration Date | 2016-05-24 |
Last Update Date | 2018-05-10 |