| NPI | 1124379433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301015984) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301015259) |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2014-09-25 |