| NPI | 1588445795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 1043404924) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 1881860658) |
| 103T00000X Psychologist (Licence: MI 1295264034) | |
| 363AM0700X Physician Assistant, Medical (Licence: MI 1003122169) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 1457081036) | |
| Enumeration Date | 2023-10-12 |
| Last Update Date | 2023-10-12 |