| NPI | 1013264225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301014591) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MI 6301014591) |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2020-01-06 |