| NPI | 1043458516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6351000450) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301013299) |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301013299) | |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2022-08-09 |