| NPI | 1568574234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301007154) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401006422) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |