| NPI | 1437713807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6362009629) |
| Additional Taxonomies | 156F00000X Technician/Technologist |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2022-11-04 |