| NPI | 1245319524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401010806) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-01407) |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301011028) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2016-08-12 |