| NPI | 1457527020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301013548) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MI 6401010610) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2009-12-07 |