| NPI | 1851713697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301005952) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401000999) |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2014-01-14 |