| NPI | 1548690704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6361003450) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6361003450) |
| 103TC0700X Psychologist Clinical (Licence: MI 6301015777) | |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2023-10-31 |