| NPI | 1497743629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801011239) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW7292) |
| 106H00000X Marriage & Family Therapist (Licence: MI 4101005523) | |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2007-07-08 |