NPI | 1619019130 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801034867) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101005763) |
Enumeration Date | 2007-02-12 |
Last Update Date | 2007-07-08 |