| NPI | 1104099696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361004204) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101007252) |
| 101YM0800X Counselor, Mental Health (Licence: MI 6451022146) | |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2022-11-14 |