| NPI | 1265862148 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MI 6301016189) | 
| Additional Taxonomies | 103TC1900X Psychologist, Counseling | 
| Enumeration Date | 2013-11-14 | 
| Last Update Date | 2015-01-06 |