| NPI | 1962790998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401012485) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101006492) |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2019-04-02 |