| NPI | 1356809131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361007652) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301017514) |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2022-01-29 |