| NPI | 1346264603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301016029) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PA PS015193) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2021-08-03 |