| NPI | 1700261989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301016940) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 6301016027) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2018-07-26 |