| NPI | 1700979838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401006969) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MI 630101724) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2012-07-05 |