| NPI | 1447220819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6201002122) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101005656) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2011-09-14 |