| NPI | 1174872881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401012494) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101006494) |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2012-09-10 |