| NPI | 1205496015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361007515) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301017916) |
| 103TC0700X Psychologist, Clinical (Licence: MI 6362000528) | |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2020-10-20 |