| NPI | 1295774560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 129734) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301018572) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2021-06-25 |