| NPI | 1306844584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 4724) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301008622) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2009-09-10 |