| NPI | 1124424874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401008170) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301016226) |
| Enumeration Date | 2014-11-07 |
| Last Update Date | 2017-04-07 |