| NPI | 1124006895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401008214) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301012061) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2010-03-05 |