| NPI | 1760561708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301016586) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS016887) |
| 103T00000X Psychologist (Licence: CA PSY21208) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2024-09-14 |