| NPI | 1396786349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301016196) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 016136-1) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2023-12-06 |