| NPI | 1003039074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NM 1630) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071-006197) |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301015856) | |
| 103TC0700X Psychologist, Clinical (Licence: SD 561) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-10-16 |