| NPI | 1942285069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801008416) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801008416) |
| 106H00000X Marriage & Family Therapist (Licence: MI 4101005120) | |
| Enumeration Date | 2005-12-12 |
| Last Update Date | 2022-10-05 |