| NPI | 1538118427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016641) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810002677) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2021-03-02 |