| NPI | 1356426308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 1999140492) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301011168) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2014-02-24 |