| NPI | 1174979819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301018807) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401015375) |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2021-01-20 |