| NPI | 1124573241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401015081) |
| Additional Taxonomies | 225800000X Recreation Therapist (Licence: MI 51630) |
| 225C00000X Rehabilitation Counselor (Licence: MI 00118070) | |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2016-08-18 |