| NPI | 1740411297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MI L13828) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI L13828) |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2009-07-31 |