| NPI | 1952545980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MI 6301006701) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6301006701) |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2014-04-18 |