| NPI | 1154652733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 2073) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301008670) |
| Enumeration Date | 2010-01-21 |
| Last Update Date | 2010-05-17 |