| NPI | 1376183749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361007718) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301018196) |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2022-08-05 |