| NPI | 1922130467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801069850) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301011930) |
| Enumeration Date | 2007-03-11 |
| Last Update Date | 2020-08-28 |