| NPI | 1295290104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 5543) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301016656) |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2019-06-18 |