NPI | 1649625823 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801098353) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: 4101006682) |
Enumeration Date | 2016-04-26 |
Last Update Date | 2020-07-06 |