| NPI | 1154002137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301019296) |
| Additional Taxonomies | 103TH0004X Psychologist Health (Licence: MI 6301019296) |
| 103TP2701X Psychologist Group Psychotherapy (Licence: MI 6301019296) | |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2024-01-31 |