| NPI | 1518564657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361007929) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6362009086) |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2024-09-04 |