| NPI | 1912063264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401000752) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 6801034288) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2007-07-08 |