| NPI | 1437104379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OK 2498) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 410-100-5645) |
| 106H00000X Marriage & Family Therapist (Licence: MI 680-100-9395) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2007-07-08 |