| NPI | 1649318346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401006382) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301010121) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2007-07-08 |