| NPI | 1366642357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.008722) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301013422) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2015-05-29 |