| NPI | 1508207770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: TX 38355) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401013721) |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2020-11-01 |