| NPI | 1205065182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6361005560) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6301014402) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2020-07-22 |