| NPI | 1972696029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801034260) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-08 |