| NPI | 1700963154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401009040) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6802021247) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2009-07-17 |