| NPI | 1679766240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301018287) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301013013) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2020-01-22 |