| NPI | 1215073929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6301006045) |
| 103TP2701X Psychologist Group Psychotherapy | |
| 103T00000X Psychologist | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2025-09-11 |