| NPI | 1306128442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301018194) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 22025) |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2022-08-04 |