| NPI | 1023081296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MI 6301006941) |
| Additional Taxonomies | 103TH0100X Psychologist Health Service (Licence: MI 6301006941) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2011-10-06 |