| NPI | 1821271974 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MI 6301013678)  | 
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: MI 6301013678)  | 
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301013678)  | |
| 103TF0000X Psychologist, Family (Licence: MI 6301013678)  | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MI 6301013678)  | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MI 6301013678)  | |
| 106H00000X Marriage & Family Therapist (Licence: MI 6301013678)  | |
| Enumeration Date | 2007-12-12 | 
| Last Update Date | 2007-12-12 |