| NPI | 1124239256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361006445) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6301010385) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2021-04-08 |