| NPI | 1275869109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301008434) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6301008434) |
| 103TF0200X Psychologist Forensic (Licence: MI 6301008434) | |
| 103TH0004X Psychologist Health (Licence: MI 6301008434) | |
| Enumeration Date | 2009-10-28 |
| Last Update Date | 2009-10-28 |