| NPI | 1730897398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY11661) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301019148) |
| Enumeration Date | 2022-11-11 |
| Last Update Date | 2023-08-09 |