| NPI | 1356401947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI SW6801067536) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI SW6801067536) |
| 1041C0700X Social Worker Clinical (Licence: MI SW6801067536) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2007-07-08 |