| NPI | 1114185782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301013806) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA Psy18410) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2008-05-29 |