| NPI | 1477697027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361007893) |
| Additional Taxonomies | 225800000X Recreation Therapist (Licence: MI 48900) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2024-01-23 |