| NPI | 1710191721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401008027) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301011702) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2007-07-08 |