| NPI | 1164660726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361002861) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301013993) |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2021-11-03 |