| NPI | 1144951542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6361007726) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6362009295) |
| Enumeration Date | 2022-06-17 |
| Last Update Date | 2022-07-27 |