| NPI | 1508079211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401007912) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101006197) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2007-07-08 |