| NPI | 1902142821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MI 4101007304) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103T00000X Psychologist (Licence: MI 6301014228) | |
| 103TC0700X Psychologist, Clinical (Licence: MI 6361006355) | |
| Enumeration Date | 2012-12-20 |
| Last Update Date | 2024-03-20 |