| NPI | 1730233313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301003342) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: MI 6301003342) |
| 103TE1100X Psychologist Exercise & Sports (Licence: MI 6301003342) | |
| 103TH0100X Psychologist Health Service (Licence: MI 6301003342) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: MI 6301003342) | |
| 103TR0400X Psychologist Rehabilitation (Licence: MI 6301003342) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2007-12-14 |