| NPI | 1306221171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301016270) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 22282) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2023-06-29 |