| NPI | 1558704395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MI 6301015370) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6802070173) |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2015-10-15 |