| NPI | 1508917014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301010955) |
| 103T00000X Psychologist (Licence: MI 6301010955) | |
| Enumeration Date | 2007-01-13 |
| Last Update Date | 2007-07-08 |