| NPI | 1205106614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301014937) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6301014937) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2023-10-28 |