| NPI | 1891725859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301010165) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801034965) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2007-07-08 |