| NPI | 1356428981 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301006452) | 
| Additional Taxonomies | 103TR0400X Psychologist, Rehabilitation (Licence: MI 6301006452) | 
| Enumeration Date | 2006-11-01 | 
| Last Update Date | 2025-09-11 |