| NPI | 1053981779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301018851) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MI 1-19-38306) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301018851) | |
| Enumeration Date | 2021-06-25 |
| Last Update Date | 2022-10-20 |