| NPI | 1700825734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 000101) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2012-09-11 |