| NPI | 1356595631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301003839) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101005206) |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2011-11-23 |