| NPI | 1164960787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016945) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401013275) |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2017-04-12 |