| NPI | 1053315960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301008875) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MI 6301008875) |
| 103TH0004X Psychologist, Health (Licence: MI 6301008875) | |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2019-12-12 |