| NPI | 1013384221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA psy004258) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301016205) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2019-10-31 |