| NPI | 1568916641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016862) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: MI 6301016862) |
| Enumeration Date | 2016-08-07 |
| Last Update Date | 2021-08-09 |