| NPI | 1760695548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MI 6301003929) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301003929) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2025-09-11 |