| NPI | 1255737649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361003728) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301003728) |
| 103TC1900X Psychologist, Counseling (Licence: MI 6301014470) | |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2022-08-05 |