| NPI | 1265610422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301013608) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301013608) |
| 103TH0004X Psychologist, Health (Licence: MI 6301013608) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MI 6301013608) | |
| 103TS0200X Psychologist, School (Licence: MI 6301013608) | |
| Enumeration Date | 2008-02-09 |
| Last Update Date | 2009-04-03 |