| NPI | 1447600549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 247200000X Technician, Other |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301017194) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2021-06-15 |