| NPI | 1972679843 |
|---|---|
| Former Name | JANE LOUISE KING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401007872) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301011029) |
| 106H00000X Marriage & Family Therapist (Licence: MI 4101006170) | |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2007-07-08 |