| NPI | 1043469661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC005850) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301012934) |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2012-08-06 |