| NPI | 1700025152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301009417) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6802018463) |
| Enumeration Date | 2009-02-09 |
| Last Update Date | 2009-02-09 |