| NPI | 1508083254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI LPC6401007347) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI LMFT4101005238) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2007-07-08 |