| NPI | 1679871073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401007603) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301011435) |
| Enumeration Date | 2011-03-09 |
| Last Update Date | 2011-03-09 |