| NPI | 1710994926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI LK012912) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301012912) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2024-11-03 |