| NPI | 1356569487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401001795) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301008167) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2007-07-08 |