| NPI | 1114120755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801035219) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101005467) |
| 163W00000X Registered Nurse (Licence: MI 4704078949) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2007-07-08 |