| NPI | 1679500078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS019893) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301005425) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2023-06-22 |