| NPI | 1528444247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801104636) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: ZZ 4867009) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: ZZ 09106083) | |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2024-04-08 |