| NPI | 1063924934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6351004413) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401018492) |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2022-09-13 |