| NPI | 1518956259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301006340) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301006340) |
| Enumeration Date | 2005-10-16 |
| Last Update Date | 2021-09-15 |