| NPI | 1003080888 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801016920) | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101005789) | 
| Enumeration Date | 2008-04-14 | 
| Last Update Date | 2008-04-14 |