| NPI | 1710138870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 33697) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301010924) |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2016-08-15 |