| NPI | 1386192409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361007294) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: 6301016879) |
| Enumeration Date | 2016-09-18 |
| Last Update Date | 2021-06-23 |