| NPI | 1376939629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016269) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY9718) |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2025-03-06 |