NPI | 1174899421 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801098813) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
106H00000X Marriage & Family Therapist (Licence: MI 4101006666) | |
Enumeration Date | 2012-03-30 |
Last Update Date | 2022-07-21 |