| NPI | 1811593098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401018949) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling |
| Enumeration Date | 2020-12-11 |
| Last Update Date | 2021-01-05 |