| NPI | 1518476753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6362005246) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301017212) |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2020-04-30 |