| NPI | 1225111057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301012416) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301012416) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2018-10-07 |