| NPI | 1184669855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301009196) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TS0200X Psychologist, School (Licence: MI 105130) | |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2019-03-25 |