| NPI | 1861725814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301014258) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801089129) |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2009-09-09 |