| NPI | 1508311218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6351004625) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: MI 6351004625) |
| 101Y00000X Counselor (Licence: MI 6351004625) | |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301016828) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6351004625) | |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2024-02-14 |