| NPI | 1316141377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: GA PSY004171) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301013431) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2023-01-12 |