| NPI | 1164695086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361000492) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401223522) |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2025-04-10 |