NPI | 1326341215 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MI 6301014740) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MI P520447650254) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-02759) | |
Enumeration Date | 2010-12-15 |
Last Update Date | 2016-04-18 |