| NPI | 1639471246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC006925) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301013232) |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2013-06-03 |