| 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 |