| NPI | 1093154437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016901) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TC1900X Psychologist, Counseling (Licence: MI 6301016901) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2023-08-28 |