| NPI | 1003956608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MI 6401006825) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301010402) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2007-07-08 |