| NPI | 1760885107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6361004348) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6361004348) |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2026-05-18 |