NPI | 1053779496 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401014130) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101006605) |
Enumeration Date | 2016-01-31 |
Last Update Date | 2017-04-19 |