NPI | 1679925705 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MI 4151001078) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
106S00000X Behavior Technician | |
175T00000X Peer Specialist | |
Enumeration Date | 2016-07-13 |
Last Update Date | 2024-05-01 |