| NPI | 1275860454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401017688) |
| Additional Taxonomies | 225800000X Recreation Therapist (Licence: MI 57274) |
| 225C00000X Rehabilitation Counselor (Licence: MI 00118456) | |
| Enumeration Date | 2009-11-10 |
| Last Update Date | 2023-03-03 |