| NPI | 1437604477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 38291) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301016796) |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2019-10-22 |