| NPI | 1194215970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6362001113) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301018366) |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2020-04-30 |