| NPI | 1609019983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: 20043222A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI L1316857) |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2019-05-06 |