| NPI | 1659603280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301013927) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6301013927) |
| Enumeration Date | 2010-02-08 |
| Last Update Date | 2023-01-10 |