| NPI | 1518454701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OK 1375) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6301017413) |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2021-03-30 |