| NPI | 1649892548 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MI 4101006919) | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 1685) | 
| Enumeration Date | 2020-05-13 | 
| Last Update Date | 2020-05-13 |