| NPI | 1669774170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH16965) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401012266) |
| 103TC1900X Psychologist, Counseling (Licence: MI 6301014682) | |
| Enumeration Date | 2010-12-03 |
| Last Update Date | 2023-08-22 |