| NPI | 1053881524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301017621) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801110290) |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2021-07-15 |