| NPI | 1649603937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 30127) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301015153) |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2025-10-01 |