| NPI | 1710214945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361002044) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301013202) | |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2022-08-10 |