| NPI | 1245881960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX Pending) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301017800) |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2020-06-04 |