| NPI | 1407947633 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301003846) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401008160) | 
| 1041C0700X Social Worker, Clinical (Licence: MI 6801019251) | |
| Enumeration Date | 2006-09-26 | 
| Last Update Date | 2025-09-11 |