| NPI | 1962084202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301019368) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6351004514) |
| 101Y00000X Counselor (Licence: NE 12548) | |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2023-11-20 |