| NPI | 1811296163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301014890) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MI 6301013485) |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2022-07-13 |