| NPI | 1134666134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019736) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6352000830) |
| 247200000X Technician, Other | |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2025-09-02 |