| NPI | 1902464035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MI 6301017897) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6361007570) |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2021-11-01 |