| NPI | 1346463965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701006136) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301013113) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2015-09-01 |