| NPI | 1215254438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 680-108-2318) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 630-101-0081) |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2010-04-27 |