| 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 |