| NPI | 1679026900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301016398) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: MI SP0000396) |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2016-08-03 |