NPI | 1730506908 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MI 4101006465) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301013877) |
Enumeration Date | 2014-03-25 |
Last Update Date | 2014-03-25 |