| NPI | 1538815204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6351004574) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 103TC0700X Psychologist, Clinical (Licence: MI 6351004574) | |
| Enumeration Date | 2022-02-22 |
| Last Update Date | 2024-10-07 |