| NPI | 1497037857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301015594) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MI 6301015594) |
| 103T00000X Psychologist (Licence: MI 6301015594) | |
| 103T00000X Psychologist (Licence: OH 6817) | |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2019-06-17 |