| NPI | 1386674497 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: GA PSY003892)  | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301003144)  | 
| Enumeration Date | 2006-07-04 | 
| Last Update Date | 2020-10-29 |