| NPI | 1245451285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401006621) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MI 6301010885) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2007-07-08 |