| NPI | 1275085417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019649) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OH 7519) |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2025-11-06 |