| NPI | 1528415254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301016381) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401015108) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2016-05-23 |