| NPI | 1164682795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801035885) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101005701) |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2008-08-26 |