| NPI | 1083963375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI L2083707) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI L2083707) |
| 101YM0800X Counselor, Mental Health (Licence: MI L2083707) | |
| 103K00000X Behavior Analyst (Licence: MI L2083707) | |
| Enumeration Date | 2012-09-03 |
| Last Update Date | 2014-01-16 |