| NPI | 1275869653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401008847) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6301013036) |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2009-10-20 |