| NPI | 1871871988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301015233) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 9447) |
| 103T00000X Psychologist (Licence: MI 6301015233) | |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2019-09-03 |