| NPI | 1114467917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301018608) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401222404) |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2024-05-06 |