| NPI | 1235507914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016484) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301016384) |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301016384) | |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2022-11-15 |