| NPI | 1639322084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361005059) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6301012424) |
| Enumeration Date | 2008-10-29 |
| Last Update Date | 2025-08-08 |