| NPI | 1730688292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301017311) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401018204) |
| Enumeration Date | 2018-02-09 |
| Last Update Date | 2020-09-16 |