| NPI | 1982708673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401009658) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801019044) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2012-01-10 |