| NPI | 1063016046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019380) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6351004500) |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2023-10-13 |