| NPI | 1770141525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TF0200X Psychologist Forensic (Licence: MI 6301017829) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301017829) |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: MI 6301017829) | |
| 103TC0700X Psychologist Clinical (Licence: MI 6301017829) | |
| 103TH0100X Psychologist Health Service (Licence: MI 6301017829) | |
| 103TC1900X Psychologist Counseling (Licence: MI 6301017829) | |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2019-06-05 |