| NPI | 1982894309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801087659) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MI 6801087659) |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2009-03-30 |