| NPI | 1578537213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 4697) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301010178) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2007-07-08 |