| NPI | 1063456093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401009761) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MI 6301011212) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2009-07-14 |