| NPI | 1124070362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 002703) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301009179) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2007-07-08 |