| NPI | 1134341845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301007167) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301098517) |
| 208000000X Pediatrics (Licence: OH 35128729) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-03-09 |