| NPI | 1609488923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301018602) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CO PSYCH.00014341) |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2021-05-19 |