| NPI | 1568740017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301014290) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301014290) |
| 103TH0004X Psychologist Health (Licence: MI 6301014290) | |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2019-12-05 |