| NPI | 1073014916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401017436) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: 6301012549) |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2022-12-27 |