| NPI | 1346788775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 38599) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301016702) |
| 103T00000X Psychologist (Licence: MI 6361005090) | |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2021-05-26 |