| NPI | 1225162621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361006583) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2025-03-04 |