| NPI | 1497126734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016105) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301019019) |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2025-05-19 |