| NPI | 1073064762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016915) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: MI 6301016915) |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2022-07-30 |