| NPI | 1346544897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801092763) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6301014865) |
| Enumeration Date | 2010-12-27 |
| Last Update Date | 2012-08-27 |