| NPI | 1568918068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MI 630101782) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401006979) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2016-08-25 |