| NPI | 1215422365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361007703) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301017462) |
| 103T00000X Psychologist | |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2022-09-02 |