| NPI | 1093719544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 63001008483) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA psy 22353) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2011-02-03 |