| NPI | 1114056918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801018746) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101005306) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2008-09-12 |