| NPI | 1194943209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301013774) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 3600) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2022-12-06 |