NPI | 1023309515 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801046362) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101005574) |
Enumeration Date | 2011-05-02 |
Last Update Date | 2011-05-02 |