| NPI | 1639666936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401016566) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301017362) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2024-08-01 |