| NPI | 1518410992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MI 6361005039) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2025-09-15 |