| NPI | 1417511395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301018724) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301018724) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2022-08-29 |