| NPI | 1033631122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MI 6301017428) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2018-05-08 |