| NPI | 1184616765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: NM 0038) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NM 1142) |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301003263) | |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2022-02-15 |