| NPI | 1104273960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401225801) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6361004417) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2026-04-04 |