| NPI | 1386836617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301014221) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801096669) |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2021-09-14 |