| NPI | 1730395013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MI 6301003396) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301003396) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MI 6301003396) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2014-04-14 |