| NPI | 1265403380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401018974) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301010530) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2021-04-27 |