| NPI | 1396899241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301007830) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: OH 5096) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2007-07-08 |