| NPI | 1467752964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NV PY1084) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6301018899) |
| Enumeration Date | 2010-10-30 |
| Last Update Date | 2025-04-04 |