| NPI | 1720376775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019037) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401009435) |
| 103T00000X Psychologist (Licence: MI 6301014433) | |
| 163W00000X Registered Nurse (Licence: MI 4704173855) | |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2023-02-17 |