| NPI | 1508852336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401222861) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 363A00000X Physician Assistant (Licence: OR PA00584) | |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2023-11-27 |