| NPI | 1477603397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301009802) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MI 6301009802) |
| 103T00000X Psychologist (Licence: MI 6301009802) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2025-09-11 |