| NPI | 1366807398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 11240) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: MI 6301016479) |
| Enumeration Date | 2015-12-17 |
| Last Update Date | 2022-07-21 |