| NPI | 1902817828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301012467) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MI 6401008366) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2007-07-08 |