| NPI | 1477230837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6362009776) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2024-07-26 |