| NPI | 1235301656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361000599) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6361000599) |
| 103TC1900X Psychologist, Counseling (Licence: MI 6361000599) | |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2021-11-15 |