| 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 |