| NPI | 1205284056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301016633) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: MI PP0000000769584) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2016-06-01 |