| NPI | 1760715320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361006417) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301013555) |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2021-09-10 |