| NPI | 1225020415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401011622) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MI 6301009291) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2023-01-18 |