| NPI | 1356436208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401006044) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301009779) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2022-08-17 |