| NPI | 1407947633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401008160) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301003846) |
| 1041C0700X Social Worker Clinical (Licence: MI 6801019251) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-07-08 |