| NPI | 1487898763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361003059) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301013832) |
| 103TC0700X Psychologist Clinical (Licence: MI 6301013832) | |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2022-08-05 |