| NPI | 1396986071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6161007092) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301007221) |
| Enumeration Date | 2009-03-10 |
| Last Update Date | 2021-03-30 |