| NPI | 1538148796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401009340) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: MI 6301010895) |
| Enumeration Date | 2006-01-15 |
| Last Update Date | 2011-07-26 |