| NPI | 1336357953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 4314) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301002254) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2013-04-17 |