| NPI | 1457698946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401013385) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: MI 6301015336) |
| Enumeration Date | 2013-01-03 |
| Last Update Date | 2013-01-03 |