| NPI | 1417456930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019077) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6351004336) |
| Enumeration Date | 2018-02-10 |
| Last Update Date | 2022-06-21 |