| NPI | 1588967970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801092139) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101006469) |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2010-12-07 |