| NPI | 1023179074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: VA 0717001308) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 1652954) |
| 106H00000X Marriage & Family Therapist (Licence: MI 1479046) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2015-06-08 |