| NPI | 1700967486 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301007083) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6301007083) | 
| Enumeration Date | 2006-10-18 | 
| Last Update Date | 2018-06-18 |