| NPI | 1144277450 |
|---|---|
| Other Name | NONE NONE NONE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301002736) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801015521) |
| 106H00000X Marriage & Family Therapist (Licence: MI 4101006294) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2022-07-21 |