| NPI | 1114295201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401012458) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6401012458) |
| Enumeration Date | 2011-12-05 |
| Last Update Date | 2021-02-22 |