| NPI | 1043640493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NM PA-1478) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301015077) |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2018-03-17 |