| NPI | 1063625432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 12665) |
| 101YP2500X Counselor, Professional (Licence: MI 6401009343) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2024-01-05 |