| NPI | 1700205580 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MI 6401015188) | 
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6802086823) | 
| Enumeration Date | 2014-04-09 | 
| Last Update Date | 2017-04-26 |