| NPI | 1255585436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MI 6301012397) |
| Additional Taxonomies | 103TH0004X Psychologist Health (Licence: MI 6301012397) |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2012-08-10 |