| NPI | 1942737937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301017659) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 11156) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2018-10-03 |