| NPI | 1215943154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361004620) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI MIQUAK3371B) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2021-03-17 |