| NPI | 1275651812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301011888) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6301011888) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2023-09-15 |