| NPI | 1023739596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401008415) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-01766) |
| 103TS0200X Psychologist, School (Licence: MI SP0000002) | |
| 103TS0200X Psychologist, School (Licence: SP) | |
| Enumeration Date | 2022-09-05 |
| Last Update Date | 2022-09-05 |