| NPI | 1548462039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401008808) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101006290) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2007-07-08 |