| NPI | 1255856142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361007695) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 103T00000X Psychologist | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-08-11 |
| Last Update Date | 2023-04-21 |