| NPI | 1730467812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016242) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2011-07-24 |
| Last Update Date | 2020-09-30 |