| NPI | 1154318806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 07010001257) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401010056) |
| 106H00000X Marriage & Family Therapist (Licence: VA 0717000110) | |
| 106H00000X Marriage & Family Therapist (Licence: MI 4101006334) | |
| Enumeration Date | 2005-09-28 |
| Last Update Date | 2007-07-08 |