| NPI | 1669725347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301017943) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2024-08-13 |