| NPI | 1679209688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 5381-57) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6362009549) |
| Enumeration Date | 2022-08-01 |
| Last Update Date | 2026-04-27 |