| NPI | 1679699920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361000315) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401008033) |
| 103T00000X Psychologist | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2022-08-04 |