| NPI | 1548939846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019285) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS019330) |
| Enumeration Date | 2021-09-09 |
| Last Update Date | 2025-09-16 |