| NPI | 1629345988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MI 6361001841) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6361001841) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2020-09-10 |