| NPI | 1194156927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MI 6301015779) |
| Additional Taxonomies | 103TF0000X Psychologist Family (Licence: MI 6301015779) |
| Enumeration Date | 2013-12-04 |
| Last Update Date | 2013-12-04 |