| NPI | 1417150889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301014092) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL LMHC MH3449) |
| 101YP2500X Counselor, Professional (Licence: MI LPC6401008439) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2012-05-21 |