| NPI | 1457493686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 1973) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301005104) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2010-12-21 |