| NPI | 1225158306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301014348) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301014348) |
| 103TC1900X Psychologist Counseling (Licence: MI 6301014348) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2024-05-30 |