| NPI | 1245603711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301016473) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6361005138) |
| 103TC0700X Psychologist Clinical (Licence: MI 6301016473) | |
| 103TC0700X Psychologist Clinical (Licence: MI 6361005138) | |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2022-08-05 |