| NPI | 1750709564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301016259) |
| Additional Taxonomies | 247200000X Technician, Other |
| 104100000X Social Worker (Licence: MI 6301016259) | |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2015-05-21 |