| NPI | 1508275306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301014984) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2021-03-08 |