| NPI | 1861968638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019134) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401009648) |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2022-12-30 |