| NPI | 1679007637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401018810) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101006765) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2020-11-19 |