| NPI | 1376750281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301012132) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: MI 6301012132) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2012-12-17 |