| NPI | 1275645665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 63010103394) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-00012) |
| 103TC0700X Psychologist, Clinical (Licence: MI 63010103394) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-02-06 |