| NPI | 1700159670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301012698) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: MI 6301012698) |
| 103TC0700X Psychologist Clinical (Licence: MI 6301012698) | |
| 103TH0004X Psychologist Health (Licence: MI 6301012698) | |
| 103TH0100X Psychologist Health Service (Licence: 6301012698) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: MI 6301012698) | |
| 103TR0400X Psychologist Rehabilitation (Licence: MI 6301012698) | |
| Enumeration Date | 2012-02-22 |
| Last Update Date | 2018-02-23 |