| NPI | 1023447901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401010206) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301013445) |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2019-08-22 |