| NPI | 1699835611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361003125) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301008519) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2021-12-03 |