| NPI | 1720602857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401018321) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4151000530) |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2020-06-04 |