| NPI | 1932396876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361000780) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6361000780) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-01630) | |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2025-11-18 |