| NPI | 1619959400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MI 6301010100) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301010100) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2022-07-21 |