| NPI | 1689993412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301014426) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401011845) |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2010-07-12 |