| NPI | 1578923322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401015151) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101006663) |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2016-03-07 |