| NPI | 1013214824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 5010-125) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: MI 6301014744) |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2013-03-26 |