| NPI | 1043267040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361001644) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MI 6301008586) |
| 101YP2500X Counselor, Professional (Licence: MI 6401010065) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2021-03-10 |