| NPI | 1942304209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MI 6401002019) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 6801034504) |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2007-07-08 |