| NPI | 1063061679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019210) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301017966) |
| Enumeration Date | 2019-09-06 |
| Last Update Date | 2022-11-20 |