| NPI | 1730587205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 64510223071) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: MI 820103) |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2024-05-23 |