| NPI | 1669417291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 630101005) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 630101005) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2024-04-13 |