| NPI | 1568605475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301016720) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301016720) | |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2024-10-30 |