| NPI | 1386749240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MI 6401009453) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301007523) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2009-07-22 |