| NPI | 1407832546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301010069) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 6801018098) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2013-05-16 |