| NPI | 1417618372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361003880) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: MI 6301007406) |
| Enumeration Date | 2022-01-04 |
| Last Update Date | 2022-05-16 |