| NPI | 1396908117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301015469) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MI 6401008979) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2015-08-30 |