| NPI | 1447585450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301019122) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 3738) |
| 103T00000X Psychologist (Licence: NE 1033) | |
| 103TH0004X Psychologist, Health (Licence: MI 6301019122) | |
| 1041C0700X Social Worker, Clinical (Licence: FL 11091) | |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2024-01-09 |