| NPI | 1063951671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301014919) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301017663) |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2019-05-01 |