| NPI | 1124457452 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016013) | 
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6803086290) | 
| Enumeration Date | 2013-11-07 | 
| Last Update Date | 2023-02-07 |