| NPI | 1598002610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301015342) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 6801082847) |
| Enumeration Date | 2013-01-09 |
| Last Update Date | 2013-05-06 |