| NPI | 1538312111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: MI 6301017728) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: OR 3153) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2020-11-03 |