| NPI | 1235645417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401016599) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301017303) |
| Enumeration Date | 2017-12-25 |
| Last Update Date | 2020-03-15 |