| NPI | 1578963336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016781) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801087564) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2019-03-21 |