| NPI | 1619910643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301007497) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401004128) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2009-04-01 |