| NPI | 1689397135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019203) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6351004507) |
| Enumeration Date | 2022-09-20 |
| Last Update Date | 2023-03-10 |