| NPI | 1245745298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301018411) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301018411) |
| 103TC0700X Psychologist, Clinical (Licence: OH P.07682) | |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2023-03-20 |