| NPI | 1295163129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301014558) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2016-10-31 |