| NPI | 1710219159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301014399) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6301014399) |
| Enumeration Date | 2010-02-10 |
| Last Update Date | 2010-03-03 |