| NPI | 1417380007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301014080) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WV 840) |
| 103TH0004X Psychologist, Health (Licence: MI 6301014080) | |
| 103TH0004X Psychologist, Health (Licence: WV 840) | |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2013-08-19 |