| NPI | 1366923831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301017457) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: MI 6301017457) |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2019-12-06 |