| NPI | 1679630222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361005162) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301009310) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2025-10-02 |