| NPI | 1104969930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801079203) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MI 6801079203) |
| 1041C0700X Social Worker Clinical (Licence: MI 6801079203) | |
| 106H00000X Marriage & Family Therapist (Licence: MI 6801079203) | |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2014-03-24 |