| NPI | 1760812820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361002821) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301014382) |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2023-05-04 |