| NPI | 1033251384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301007114) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: MI 139703) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2007-07-08 |