| NPI | 1245797406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MI 6362009892) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2024-03-04 |