| NPI | 1164727442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401008219) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301011415) |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2011-01-19 |