NPI | 1407065758 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801065390) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101006323) |
Enumeration Date | 2007-05-22 |
Last Update Date | 2023-05-01 |