| NPI | 1013914274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301002452) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101005257) |
| Enumeration Date | 2005-07-03 |
| Last Update Date | 2007-07-08 |