| NPI | 1639592546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301004065) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801033244) |
| Enumeration Date | 2014-01-28 |
| Last Update Date | 2014-01-28 |