| NPI | 1699742361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MI 6401009555) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301012938) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2017-04-12 |