| NPI | 1609836105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 03975) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301006723) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2016-10-17 |