| NPI | 1134569635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301014863) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: MI CC7C3800099544) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2013-06-28 |