| NPI | 1457980476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019355) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA PSY50000290) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2023-12-20 |