| NPI | 1598346546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6361007516) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 225XM0800X Occupational Therapist Mental Health | |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2021-06-14 |