| NPI | 1770913832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6301015678) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6361004924) |
| 103T00000X Psychologist (Licence: MI 6301015678) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: MI 6301015678) | |
| 103TC1900X Psychologist, Counseling (Licence: MI 6301015678) | |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2022-09-18 |