NPI | 1619317096 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401013120) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6351004342) |
Enumeration Date | 2013-06-28 |
Last Update Date | 2023-08-08 |