| NPI | 1154920429 |
|---|---|
| Former Name | MIKAELA OVERTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: ID 6261175) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6352000475) |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2026-07-09 |