NPI | 1609914027 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801034598) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101005263) |
Enumeration Date | 2007-02-01 |
Last Update Date | 2007-07-08 |