| NPI | 1912943390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801016562) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101305788) |
| 106H00000X Marriage & Family Therapist (Licence: MI 4101005788) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2015-09-09 |