| NPI | 1730671546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016596) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6361007511) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2021-04-28 |