| NPI | 1871647180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI 1 011629) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 6801003338) |
| 106H00000X Marriage & Family Therapist (Licence: MI 4101005975) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2007-07-08 |