| NPI | 1003197245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 251S00000X (Licence: MI 6301015236) | |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2018-10-18 |