| NPI | 1669843850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6352000039) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301016427) |
| 103TH0100X Psychologist, Health Service (Licence: MI 6352000039) | |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2022-05-03 |