| NPI | 1083091037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MI 6301013038) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MI 6401009696) |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2015-04-29 |