| NPI | 1326592957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 630-101-6779) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103T00000X Psychologist (Licence: MI 6301016779) | |
| 103TC0700X Psychologist, Clinical (Licence: MI 6361003181) | |
| 247200000X Technician, Other | |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2023-09-10 |