| NPI | 1598764219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361002972) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MI 5201002009) |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2022-10-24 |