| NPI | 1649459397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC P-3786) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 630101257) |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301011257) | |
| 103TC0700X Psychologist, Clinical (Licence: IL 071005134) | |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2012-01-13 |