| NPI | 1366866337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401012491) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101006564) |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2015-10-14 |