| NPI | 1134986490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019379) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810005709) |
| Enumeration Date | 2024-03-04 |
| Last Update Date | 2024-03-04 |