| NPI | 1083821953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301011533) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301011533) |
| 1041C0700X Social Worker, Clinical (Licence: MI 6801083651) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2016-01-05 |