| NPI | 1083057780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801104080) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301009477) |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2023-08-31 |