| NPI | 1376966572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6451022680) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: MI 6301015813) |
| Enumeration Date | 2014-01-24 |
| Last Update Date | 2023-08-01 |