| NPI | 1518983675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301010354) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY6074) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2007-07-08 |