| NPI | 1083982425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016305) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 019395) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2016-12-12 |